硬膜外导管与某些风险相关,例如意外移除硬膜外导管。包括移位和断开。全球范围内,2016年对神经轴连接器的设计进行了修订,以提供新的标准化,旨在减少用药期间的错接频率.然而,没有研究调查修订后的标准化后意外拔除硬膜外导管.本研究旨在检查与不同导管连接器类型相关的移位和断开率的差异。并研究引起断开所需的线性拉伸强度。
这项回顾性队列研究包括接受择期手术并接受患者自控硬膜外镇痛的成年患者。根据使用的导管连接类型将患者分为几组:旧标准,新标准,和新的标准与录音组。此外,我们为每个老年人准备了60套硬膜外导管和连接器,包括20套,新,和录音组,并使用数字张力计来测量引起断开所需的最大抗拉强度。
这项临床研究涉及360、182和378名老年患者,新,和录音组,分别。三组之间的移位率没有统计学差异,而断流率有显著差异。断流率的倾向评分匹配分析显示,新旧组之间没有差异(2.8%与4.5%,p=0.574),而新组的发病率高于录音组(6.5%vs.0%,p=0.002)。这项实验室研究确定了12.41N的抗拉强度,12.06N,旧的断开需要19.65N,新,和录音组,分别,并显示新组和老组之间没有显着差异(p=0.823),但表明新组和录音组之间存在显着差异(p<0.001)。
这项临床研究表明,三组间的移位率没有变化。临床和实验室研究均表明,新旧连接器之间的断开连接率没有变化。此外,作为预防事故的策略,用胶带绑扎导管连接器的连接点导致断开所需的抗拉强度增加。
Epidural catheters are associated with certain risks such as accidental epidural catheter removal, including dislodgement and disconnection. Globally, neuraxial connector designs were revised in 2016 to provide new standardization aimed at decreasing the frequency of misconnections during the administration of medications. However, no studies have investigated accidental epidural catheter removal after the revised standardization. This study aimed to examine differences in dislodgement and disconnection rates associated with different catheter connector types, and to investigate the linear tensile strength required to induce disconnection.
This retrospective cohort study included adult patients who underwent elective surgery and received patient-controlled epidural analgesia. Patients were divided into groups according to the type of catheter connection used: old standard, new standard, and new standard with taping groups. Furthermore, we prepared 60 sets of epidural catheters and connectors comprising 20 sets for each of the old, new, and taping groups, and used a digital tension meter to measure the maximum tensile strength required to induce disconnection.
This clinical study involved 360, 182, and 378 patients in the old, new, and taping groups, respectively. Dislodgement rates did not differ statistically among the three groups, while there was a significant difference in disconnection rates. Propensity score matching analysis for disconnection rates showed no difference between the old and new groups (2.8% vs. 4.5%, p = 0.574), while the new group had higher rates than the taping group (6.5% vs. 0%, p = 0.002). This laboratory study identified that a tensile strength of 12.41 N, 12.06 N, and 19.65 N was required for disconnection in the old, new, and taping groups, respectively, and revealed no significant difference between the new and old groups (p = 0.823), but indicated a significant difference between the new and taping groups (p < 0.001).
This clinical study suggested that dislodgement rates did not change among the three groups. Both clinical and laboratory studies revealed that disconnection rates did not change between the old and new connectors. Moreover, as a strategy to prevent accidents, taping the connecting points of the catheter connectors led to an increase in the tensile strength required for disconnection.